Myofascial Pain and Trigger Points By: Brooke Petho (Grand Valley State University)


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  • What I want to do today is
  • MPSWhy does it increase with age? By becoming inactive muscles and tendons and ligaments loose their flexibility increasing more tension, nutritional deficiency, it Is thought that muscles is younger individuals are better able to handle stress and overuseWhy is it so much more prevalent in women
  • Let me begin by explaining what myofascial is, it is actually a combination of 2 latin wordsAnalogy: Think of a piece of steak, the thin tissue on it, that’s fascia. Or, here is another way to think of it, Spider Web
  • Analogy: Think of a piece of steak, the thin tissue on it, that’s fascia. Or, here is another way to think of it, Spider WebIt surrounds every structure in the body
  • AKA Knot-NoduleTransition???
  • Correlation betweenHow they relate to one another, how does trigger points relate to MFPMFP is an umbrella term that is given to Trigger points and referred pain
  • i.e. massage therapist, AT’s, chiropractors, doctors
  • Now that you have a better understanding lets talk about MFPSRepetitive motions- constantly reaching, sitting with poor posture, staring at a computer screen
  • The two most common types of trigger points that we deal with are active and latent trigger points
  • Pain during activity and at rest
  • Meaning pain from the trigger point causes pain in a different part of the body away from the true source of the pain
  • Structural muscles
  • The most important criteria for differential diagnosis are the presence of tender points (TePs) and widespread, nonspecific, soft tissue pain in FM, compared with regional and characteristic referred pain patterns with discrete muscular trigger points (TrPs) and taut bands of skeletal muscle in MPS.Be able to describe all of these
  • In the industrial settingOverhead motionsFind a better stress pictures
  • Self evaluationDo you exercise on a daily bases and if so what type of exercise do you do? Strengthening? Or just cardio?
  • Technique used to help lengthen the muscle and fascial layers and enable them to remain in the lengthened state
  • HVPC-muscles spasms can be released, in the muscle is continuously stimulated to exhaustion If ice makes it feel better that is a sign of nerve entrapment If ice makes it worse and heat reliefs the pain, then there is no nerve entrapment
  • Myofascial Pain and Trigger Points By: Brooke Petho (Grand Valley State University)

    1. 1. Myofascial Release: Myofascial Pain andTrigger Points By: Brooke Petho
    2. 2.  How many here know what Myofascial Pain is?  How many know what a trigger point is?  How many have experienced a tightness in your muscles causing you to lose ROM and cause pain?
    3. 3.  Provide facts and understand of myofascial pain syndrome (MPS) and trigger points (TrPs)  Provide you with techniques to self treat MPS andTrPs  Provide guidelines for the prevention of MPS andTrPs
    4. 4.  Currently reported to affect approximately 85% of the population at some point during their lives  The mean prevalence of this condition among middle-aged adults (30–60 years) is reported to be 37% in men and 65% in women, respectively  In the elderly (>65 years), the prevalence reaches 85%
    5. 5.  Combination of two Latin words  “Myo” meaning muscle  “Fascia”- meaning connective tissue surrounding the muscle
    6. 6.  Tough connective tissue that lies just under the skin  It surrounds every organ, muscle, bone, nerve and blood vessel  Extends uninterrupted from head to toe
    7. 7.  Hypersensitive areas  Palpated as a nodule within a tight band of muscle  Can cause pain, tingling, burning, weakness and loss of range of motion (ROM)
    8. 8.  MFP is an umbrella term that is given toTrPs and referred pain  TrPs are theTRUE source of soft tissue pain  MPS is more of a medical “garbage” term expressing the fact that the person is experiencing broad soft tissue pain unrelated to any MOI- possibly the result of multipleTrPs with referred pain  Tight MF and/or tight, fatigue, strained muscles can develop activeTrPs therefore creating pain
    9. 9. * Most research about myofascial release is more based on opinion, it is based on the professional, the techniques they use and the outcomes they are observing based on their practice.
    10. 10.  Chronic or acute pain disorder  Initiated troughTrP’s, inducing referred pain into a specific body region depending on the muscle involved  Typically occurs after a muscle has been contracted repetitively  Untreated it can cause tightness, tenderness, stiffness, popping and clicking, loss of ROM
    11. 11. 2Types • Latent • Active
    12. 12. • Only painful upon stimulation, stiffness, decrease in ROM
    13. 13. • When a latent trigger point becomes hyperactive, resulting in a localized spasm, creating a palpable knot, and producing referred pain.
    14. 14.  “Pain that arises in a trigger point, but is felt at a distance, often entirely remote from the source”
    15. 15.  Prevalent in the head, neck, shoulders, hips and low back
    16. 16.  Tight muscle  Tender points in muscle  Palpable nodules  Decreased range of motion  Weakness without atrophy  As "dull," "achy," or "deep” pain that radiates and is non specific  Arises without a determined MOI  Local spasm in affected muscle
    17. 17.  Sciatica  Migraine headaches  Fibromyalgia  Shoulder Impingement  Plantar fasciitis  ITB syndrome  Thoracic Outlet Syndrome
    18. 18. Stress Posture Ergonomics
    19. 19.  History  How long has this been going on?  Has anything in your daily routine changed that might evoke this?  What makes it better or worse?  Has there been any trauma to this area currently?  Any limitations of ROM since onset?  Do you notice a decrease in pain over the weekend?  What type of work do you do?
    20. 20.  What is your posture like?  How are your workstation ergonomics?  Do you exercise on a daily bases?
    21. 21.  Technique used to help lengthen the muscle and fascial layers and enable them to remain in the lengthened state  Goal is to decrease the amount of tension to the trigger points and decrease their hypersensitivity
    22. 22. SELFTREATMENTS  Stretching  Massage  Heat or Ice  Foam Roller  Trigger Ball  Strengthening MEDICALTREATMENTS  Trigger Point Injections  Acupuncture REHABILITATION  Ultrasound  Stretch and Spray  Therapeutic massage  Electrical Stimulation
    23. 23.  Ergonomics  Microbreaks  PostureTraining  Exercise  Stress Management
    24. 24. 1. Myofascial pain andTrPs are caused from a contraction of the muscle fibers, such as repetative motions or injury 2. Self techniques that help enhance the treatment of MPS andTrPs include stretching, strengthening, foam rolling and massage 3. Techniques involved in the prevention include microbreaks, postural training, exercise and stress management